205 results match your criteria: "San Raffaele Scientific Institute IRCCS[Affiliation]"

Objective: Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA.

Design: Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded.

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Background: No specific triglyceride-lowering therapy is recommended in patients with hypertriglyceridemia-associated acute pancreatitis (HTG-AP), primarily because of the lack of quality evidence. This study aimed to describe practice variations in triglyceride-lowering therapies for early HTG-AP patients and assess whether more rapid triglyceride decline is associated with improving organ failure.

Methods: This is a multicentre, prospective cohort study recruiting HTG-AP patients with elevated plasma triglyceride (> 11.

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Article Synopsis
  • Stent misdeployment (SMD) is a significant challenge in EUS-guided choledochoduodenostomy (EUS-CDS) for treating malignant distal biliary obstruction, with the study aiming to define its rate and outcomes, and propose a classification system.
  • In a review of data from two randomized controlled trials involving 152 patients, SMD was found in 7.2% of cases, with most types being misdeployments of the distal flange (type I) and a small number causing minor adverse events.
  • The analysis revealed that a smaller extrahepatic bile duct diameter (≤ 15 mm) increases the likelihood of SMD or technical failures, but most misdeployments can be successfully managed
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  • The text refers to a correction made to a previously published article.
  • The specific article mentioned can be identified by its DOI, which is 10.1055/a-2411-1814.
  • Corrections like this are common in academic publishing to address errors or inaccuracies in research.
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Background: Some evidence suggests that fluid resuscitation with lactated Ringer's solution (LR) may have an anti-inflammatory effect on acute pancreatitis (AP) when compared to normal saline (NS) and may be associated with a decrease in severity, but existing single-center randomized controlled trials showed conflicting results. The WATERLAND trial aims to investigate the efficacy and safety of fluid resuscitation using LR compared to NS in patients with AP.

Methods: The WATERLAND trial is an international multicenter, open-label, parallel-group, randomized, controlled, superiority trial.

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Article Synopsis
  • - The study investigated outcomes of lumen-apposing metal stents (LAMS) placement in patients with surgically altered anatomy (SAA), which is not well-documented in existing literature, involving 270 patients across 25 tertiary care centers up to November 2023.
  • - Technical success of the procedures was very high at 98%, with clinical success at 97%, although there was a notable adverse event rate of 12%, with various degrees of severity recorded.
  • - The results suggest that while LAMS placement in SAA is effective, due to the risk of complications, these procedures should only be performed by experienced endoscopists in specialized centers.
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Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with patients having unresectable or metastatic disease at diagnosis, with poor prognosis and very short survival. Given that genetic variation within autophagy-related genes influences autophagic flux and susceptibility to solid cancers, we decided to investigate whether 55,583 single nucleotide polymorphisms (SNPs) within 234 autophagy-related genes could influence the risk of developing PDAC in three large independent cohorts of European ancestry including 12,754 PDAC cases and 324,926 controls. The meta-analysis of these populations identified, for the first time, the association of the BID variant with an increased risk of developing the disease (OR = 1.

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Glioblastoma (GBM) is the most common malignant primary brain cancer that, despite recent advances in the understanding of its pathogenesis, remains incurable. GBM contains a subpopulation of cells with stem cell-like properties called cancer stem cells (CSCs). Several studies have demonstrated that CSCs are resistant to conventional chemotherapy and radiation thus representing important targets for novel anti-cancer therapies.

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Background: Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings.

Objective: This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients.

Methods: This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1-month follow-up.

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Correlation between endoscopic ultrasound features and exocrine pancreatic function in chronic pancreatitis.

Pancreatology

September 2024

Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address:

Background: Endoscopic ultrasound (EUS) is the most sensitive method for diagnosing chronic pancreatitis (CP) in its early stages, and Rosemont Classification (RC) is used for its evaluation. Data on the correlation between EUS features and pancreatic exocrine insufficiency (PEI) are limited. We investigated the correlation between the EUS findings and PEI.

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Article Synopsis
  • Intraductal oncocytic papillary neoplasms (IOPNs) are now identified as distinct from intraductal papillary mucinous neoplasms (IPMNs), with limited information on their recurrence and survival outcomes.
  • A study analyzed outcomes of 415 patients with invasive IOPNs and adenocarcinoma from IPMN over a median of 6 years, finding similar recurrence rates between invasive IOPNs and ductal A-IPMN, but poorer survival compared to colloid A-IPMN.
  • The research concluded that invasive IOPNs behave like aggressive cancers, with adjuvant chemotherapy showing no significant impact on recurrence rates in any of the studied cancer types.
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The i-EUS consensus on the management of pancreatic fluid collections - Part 1.

Dig Liver Dis

October 2024

Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT, Palermo, Italy.

Pancreatic fluid collections (PFCs), including pancreatic pseudocysts (PPs) and walled-off pancreatic necrosis (WON), are common complications of pancreatitis and pancreatic surgery. Historically, the treatment of these conditions has relied on surgical and radiological approaches; however, it has later shifted toward an endoscopy-based approach. With the development of dedicated lumen-apposing metal stents (LAMS), interventional Endoscopic Ultrasound (EUS)-guided procedures have become the standard approach for PFC drainage.

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The 1st i-EUS consensus on the management of pancreatic fluid collections - Part 2.

Dig Liver Dis

November 2024

Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT, Palermo, Italy.

Pancreatic fluid collections (PFCs), including pancreatic pseudocysts (PPs) and walled-off pancreatic necrosis (WON), are common complications of pancreatitis and pancreatic surgery. Historically, the treatment of these conditions has relied on surgical and radiological approaches. The treatment of patients with PFCs has already focused toward an endoscopy-based approach, and with the development of dedicated lumen-apposing metal stents (LAMS), it has almost totally shifted towards interventional Endoscopic Ultrasound (EUS)-guided procedures.

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Article Synopsis
  • The study examines the outcomes of different precursor epithelial subtypes of adenocarcinoma from intraductal papillary mucinous neoplasms (A-IPMN), focusing on clinical features and recurrence patterns among patients who underwent pancreatic surgery.
  • A total of 297 patients were analyzed, revealing that gastric, pancreatobiliary, and mixed subtypes have similar outcomes that are worse than the intestinal subtype in terms of recurrence and overall survival.
  • The research found that adjuvant chemotherapy specifically improved survival rates in the pancreatobiliary subtype, but not in gastric, intestinal, or mixed subtypes, indicating a potential area for further exploration in treatment strategies.
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  • - The study investigates factors affecting long-term survival and recurrence in patients with adenocarcinoma from intraductal papillary mucinous neoplasms, focusing on those who had pancreatic resection between 2010 and 2017 in Europe and Asia.
  • - It analyzed data from 288 patients, revealing that 48% experienced recurrence within about 98 months, with 35% remaining disease-free at the 5-year mark.
  • - Key negative predictors for long-term disease-free survival included multivisceral resection, tumor location in the pancreatic tail, poor differentiation, lymphovascular invasion, and perineural invasion, leading to the development of a predictive model with a good success rate.
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Exocrine pancreatic insufficiency: more compromise than precision.

Hepatobiliary Surg Nutr

June 2024

Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy.

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Introduction: Tetanus is a rather rare disease in the Western countries thanks to widespread vaccination programs and the availability of prophylactics for patients with tetanus-prone injuries. The few cases that do occur are promptly managed in intensive care units (ICUs). However, tetanus is not so rare in developing countries, where access to a suitable level of care is limited.

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Article Synopsis
  • A study was conducted to determine the effects of adjuvant chemotherapy on patients with adenocarcinoma from intraductal papillary mucinous neoplasia after surgical resection, analyzing data from 459 patients across 18 centers between 2010 and 2020.
  • The results showed that 59.9% of patients received various chemotherapy regimens, but there was no significant difference in recurrence rates or survival outcomes between those who received chemotherapy and those who did not.
  • Overall, the study concluded that adjuvant chemotherapy does not appear to improve recurrence patterns or survival rates in this patient population.
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There is a paucity of information on how to select the most appropriate unrelated donor (UD) in hematopoietic stem cell transplantation (HSCT) using posttransplant cyclophosphamide (PTCy). We retrospectively analyzed the characteristics of 10/10 matched UDs (MUDs) and 9/10 mismatched UDs (MMUDs) that may affect transplant outcomes in patients with acute myeloid leukemia (AML) in first or second complete remission (CR1 or CR2). The primary end point was leukemia-free survival (LFS).

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Objectives: Despite the large burden of critically ill patients in developing countries, mechanical ventilation (MV) is scarce in these low-resource settings. In the absence of data, issues like costs and lack of training are often felt to outweigh the benefits of potential MV implementation in such places. We aimed to investigate the impact and feasibility of MV in a surgical ICU in West Africa.

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Background: Biliary tract cancers (BTCs) are rare and lethal cancers, with a 5-year survival inferior to 20%(1-3). The only potential curative treatment is surgical resection. However, despite complex surgical procedures that have a remarkable risk of postoperative morbidity and mortality, the 5-year survival rate after radical surgery (R0) is 20-40% and recurrence rates are up to ~ 75%(4-6).

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Article Synopsis
  • The study aimed to compare long-term cancer outcomes between patients with adenocarcinoma from intraductal papillary mucinous neoplasms (A-IPMN) and pancreatic ductal adenocarcinoma (PDAC) after surgical resection.
  • Data revealed that A-IPMN patients generally had better survival rates and lower recurrence rates compared to PDAC patients, including longer median survival (39.0 months for A-IPMN vs. 19.5 months for PDAC).
  • While A-IPMN showed higher rates of peritoneal and lung recurrence, PDAC had more locoregional recurrences, but overall, systemic recurrence rates were similar between the two groups.
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  • * Involving 2200 patients, the findings revealed that factors such as older donor age, use of female donors for male recipients, and the choice of peripheral blood donation were linked to poorer survival outcomes and increased risks of complications.
  • * The research suggests that prioritizing younger donors and male donors for male recipients can enhance transplant success, and utilizing bone marrow instead of peripheral blood may help reduce incidences of GVHD.
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